These are injection techniques that do exactly the opposite of surgery.They rebuild and strengthen damaged tissue as opposed to removing them. Prolotherapy is the injection of mild irritants, i.e, Dextrose,PRP is the injection of the patient’s own platelet rich plasma derived from a blood draw.Stem Cell Therapy is an injection of stem cells drawn from the patients own fat.

This treatments are often used in combination

The Use of Prolotherapy
Recent medical studies on both treatments support that articular cartilage and meniscal tissue can regrow with Prolotherapy treatment. (1,2)

The Use of PRP
New research suggest PRP can be a very effective treatment for knee defects: Researchers writing in the International Journal of the Care of the Injured wrote: “(this treatment) is a simple, low-cost, minimally invasive way to apply PRP growth factors to chronic patellar tendinosis…20 male athletes with a mean history of 20.7 months of pain received treatment, and outcomes were prospectively evaluated at 6 months follow-up. No severe adverse events were observed, and statistically significant improvements in all scores were recorded. The results suggest that this method may be safely used for the treatment of jumper’s knee, by aiding the regeneration of tissue which otherwise has low healing potential. (3)

In the medical journal International Orthopaedics, researchers noted: “Histological examination and study of angiogenesis showed that the application of PRP enhances and accelerates the tendon healing process.” (4)

Prolotherapy works as an irritant using dextrose (a simple sugar) is introduced in the knee. This causes the immune system of the body to accelerate the inflammatory process.More inflammation? The body’s natural healing response is inflammation. Only when complete healing does not occur does inflammation become chronic and problematic.

What this new inflammation does is bring fribroblast and condrocytes, those cells necessary to rebuild the collagen matrix of the tissue, strengthen and restoring them to preinjury form in many cases.

In Platelet rich plasma therapy, blood is drawn from the patient and is used instead of dextrose. The principle is the same except PRP is usually reserved for patients with more damage to the knee area or for high level athletes needed for a big game.

Stem Cell Therapy
Research is confirming that stem cells, drawn from a patient’s own fat can regrow cartilage. In one study the potential of intra-articular injection of mesenchymal stem cells (MSCs) was evaluated in six osteoarthritic patients. During a one-year follow-up period magnetic resonance images (MRI) at baseline and six months post-stem cell injection displayed an increase in cartilage thickness, extension of the repair tissue over the subchondral bone and a considerable decrease in the size of edematous subchondral patches in three out of six patients. – The results indicated satisfactory effects of intra-articular injection of MSCs in patients with knee OA. (5)

The Use of Ultrasound
Research in the Journal of Clinical Rheumatology says that “(Ultrasound) Sonographic needle guidance reduced procedural pain and improved the clinical outcomes and cost-effectiveness of intra-articular injections of the osteoarthritic knee.”

The researchers found that ultrasound guided injection over conventional palpation-guided methods resulted in 48% reduction in procedural pain, a 42% reduction in pain scores at outcome, 107% increase in the responder rate and with higher accuracy, less need for procedure, significantly reducing patient cost. (6)

UPDATE: Platelet Plasma Therapy BEFORE Cortisone!
Research in the International Journal of International Orthopaedics say Platelet Rich Plasma therapy BEFORE ethoxysclerol, cortisone, and/or surgical treatment!

Researchers in the Netherlands evaluated the outcome of patients with patellar tendinopathy treated with platelet-rich plasma injections (PRP) and whether certain characteristics, such as activity level or previous treatment affected the results.

What they found was: “After PRP treatment, patients with patellar tendinopathy showed a statistically significant improvement. In addition, these improvements can also be considered clinically meaningful. However, patients who were not treated before with ethoxysclerol, cortisone, and/or surgical treatment showed the improvement.” (7)

Comments

What is the. Cost of a stem cell treatment to a knee and is only one of the treatment done? What kind of equipment is used with the fat stem cells Are marrow stem cells more effective than fat stem cells for knee cartilage? Thanks

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Prolotherapy, PRP, STEM CELLS, AGE MANAGEMENT MEDICINE, and other modalities mentioned are medical techniques that may not be considered mainstream. As with any medical treatment, results will vary among individuals, and there is no implication that you will heal or receive the same outcome as patients herein. There could be pain or substantial risks involved. These concerns should be discussed with your health care provider prior to any treatment so that you have proper informed consent and understand that there are no guarantees to healing.

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